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肠道微生物群与冠心病患者他汀类药物治疗的临床反应有关。

The gut microbiota is associated with clinical response to statin treatment in patients with coronary artery disease.

机构信息

Department of Cardiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; Department of Cardiology, Affiliated Zhongshan Hospital, Dalian University, Dalian 116001, China.

Department of Gastroenterology, First Affiliated Hospital of South China University, Hengyang, Hunan Province, China.

出版信息

Atherosclerosis. 2021 May;325:16-23. doi: 10.1016/j.atherosclerosis.2021.03.007. Epub 2021 Mar 29.

Abstract

BACKGROUND

The structure and composition of the gut microbiota influence patients' response to therapeutic interventions. It is also known that the response to statin treatment can vary greatly from one patient to another, suggesting a possible connection between microbiome composition and response to statins. In the present study, we aim to explore the influence of the microbiome composition on the response to statin treatment among patients with coronary artery disease (CAD).

METHODS

A prospective cohort of 836 CAD patients enrolled from January 2016 to December 2017 was used to perform a nested case-control study. We divided 110 CAD patients into two groups according to their response to statins (good response group and poor response group) and compared their gut microbiota.

RESULTS

Our analysis reveals no significant difference in microbiome between the two groups. However, significant differences were found in the relative proportion of numerous genera between GR and PR groups. Most remarkably, we could observe that a poor response to statin treatment correlates to a significant decrease in the abundance of beneficial bacteria for the lipid metabolism (Akkermansia muciniphila (A. muciniphila) and Lactobacillus) and a significant increase in the abundance of bacteria (Holdemanella and Facecallibacterium).

CONCLUSIONS

Gut microbiota structure is associated with the response to statin. Our results suggest that manipulation of the gut microbiota composition can be an interesting and effective treatment strategy to blood lipid control among CAD patients.

摘要

背景

肠道微生物群的结构和组成会影响患者对治疗干预的反应。已知他汀类药物治疗的反应在不同患者之间差异很大,这表明微生物组组成与他汀类药物反应之间可能存在联系。在本研究中,我们旨在探讨微生物组组成对冠心病(CAD)患者他汀类药物治疗反应的影响。

方法

使用 2016 年 1 月至 2017 年 12 月期间纳入的 836 例 CAD 患者的前瞻性队列进行嵌套病例对照研究。我们根据他汀类药物的反应(良好反应组和不良反应组)将 110 例 CAD 患者分为两组,并比较了他们的肠道微生物群。

结果

我们的分析表明,两组之间的微生物群没有显著差异。然而,在 GR 和 PR 组之间,许多属的相对比例存在显著差异。最值得注意的是,我们可以观察到他汀类药物治疗不良反应与有益的脂质代谢细菌(阿克曼氏菌(A. muciniphila)和乳杆菌)的丰度显著降低,以及与细菌(亨德森氏菌和费氏杆菌)的丰度显著增加有关。

结论

肠道微生物群结构与他汀类药物反应有关。我们的结果表明,操纵肠道微生物群组成可能是一种有趣且有效的 CAD 患者血脂控制治疗策略。

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